On February 26, 2016, the CMS Center for Medicare and Medicaid Innovation (CMMI) released a memorandum and draft specification plan outlining the proposed data structure and pilot monitoring measures for the enhanced MTM model test. AMCP provided a summary of the key proposed elements that impact managed care pharmacy.
This final rule implements new medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program established under the Patient Protection and Affordable Care Act